Journal of Vascular Surgery

Aortoiliac endarterectomy (AIE) was historically the treatment of choice for aortoiliac occlusive disease. The advent of prosthetic grafts and endovascular interventions has led to a dramatic decrease in the number of AIEs being performed. Our goal was to analyze a modern series to determine the safety and efficacy of AIE in select patients.

We report the case of an 81-year-old woman with a complex thoracoabdominal aneurysm who has undergone multiple interventions, both endovascular and open, since 2010 for continued and repeated aneurysmal degeneration. Her interventions include an initial thoracic endovascular aortic repair (TEVAR) in 2010 for a descending thoracic aortic aneurysm of 6.4 cm, ascending aortic aneurysm replacement in 2014, proximal extension of TEVAR and carotid-subclavian bypass in 2016, fenestrated endovascular aneurysm repair in 2017, and finally a complete aortic arch replacement in 2018.

We report the case of an 81-year-old woman with a complex thoracoabdominal aneurysm who has undergone multiple interventions, both endovascular and open, since 2010 for continued and repeated aneurysmal degeneration. Her interventions include an initial thoracic endovascular aortic repair (TEVAR) in 2010 for a descending thoracic aortic aneurysm of 6.4 cm, ascending aortic aneurysm replacement in 2014, proximal extension of TEVAR and carotid-subclavian bypass in 2016, fenestrated endovascular aneurysm repair in 2017, and finally a complete aortic arch replacement in 2018.

Superior mesenteric artery (SMA) aneurysm (SMAA) is a fatal degeneration of the visceral arteries. Although a rarely encountered entity, it requires timely management because of the high mortality rate associated with rupture, particularly when the aneurysm is saccular in nature. As such, urgent treatment is generally indicated. We present five cases of SMAA that were managed operatively.

Indwelling urinary catheters (Foley) are routinely placed before elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm but may be unnecessary and can potentially lead to adverse urinary events (AUEs). We evaluated outcomes for these with (Foley) and without (No Foley) preoperative placement.

Transcarotid artery revascularization (TCAR) has shown comparable results to carotid endarterectomy in previous trials. The literature has reported conflicting claims of superiority of carotid endarterectomy done under local anesthesia (LA) vs general anesthesia (GA). A consensus opinion on best practices has not been reached. The objective of this study was to examine whether there is a difference in patient outcomes of TCAR done under LA compared with GA.

An 80-year-old man presented 3 years after a mitral valve replacement for mitral insufficiency with a complaint of worsening hemoptysis during the last 1.5 months. A computed tomography scan (Fig 1) to evaluate for malignant disease demonstrated a 0.8×0.7-cm pseudoaneurysm of the ascending aorta, probably related to a previous cannulation site, which was thought to be the cause of his hemoptysis. He was deemed too high risk for open surgical intervention through redo median sternotomy; therefore, an endovascular approach was sought.

Pharmacomechanical thrombolysis (PMT) is an established treatment for acute deep venous thrombosis (DVT) in selected patients. Despite significant clinical success, hemolysis may lead to acute kidney injury (AKI) with unknown longer term implications. Our aim was to characterize the rate of AKI after PMT and to identify patients at highest risk.

Anterior lumbar interbody fusion (ALIF) is a widely accepted approach for spine surgery. Vascular surgeons are increasingly being used for preoperative planning and to obtain intraoperative exposure. Many complications related to this anterior approach are vascular in nature; however, risk factors to identify these patients are poorly defined in the current literature. This study examined multiple variables and characteristics of patients undergoing ALIF to identify potential risk factors for complications.

Multiple societal guidelines recommend medical optimization and exercise therapy for patients with claudication before lower extremity revascularization (LER). However, the application of those guidelines in practice remains unknown. Our hypothesis is that vascular surgeons (VSs) are more adherent to guidelines compared with other specialists (OSs) treating claudication.

Infrapopliteal artery chronic total occlusions (CTOs) are now routinely crossed with wires in an antegrade or retrograde fashion. Luminal re-entry devices have been used in the femoropopliteal and iliac CTOs. Ultrasound-guided re-entry (Pioneer; Philips Healthcare, Best, The Netherlands) at the infrapopliteal level has not been reported. The aim of this study was to evaluate the outcomes of ultrasound-guided and Outback (Cordis, Milpitas, Calif) re-entry devices used to assist targeted re-entry in treating CTOs at the infrapopliteal level.

Popliteal artery injuries after total knee arthroplasty (TKA) are reported to be rare events. Limb loss from these injuries is thought to be even more uncommon. The occurrence and diagnosis of ischemia that develops slowly after intraoperative arterial injury have been reported only anecdotally. This event is more common than has been reported and often leads to a devastating outcome and litigation.

Delayed inferior vena cava (IVC) filter retrieval may lead to complications of IVC filter placement, including strut migration and caval erosion into adjacent organs. Whereas percutaneous techniques for removal are preferred, in certain cases this is not possible and open retrieval is necessary. We present outcomes of various approaches to six cases of open IVC filter retrieval.

Delayed inferior vena cava (IVC) filter retrieval may lead to complications of IVC filter placement, including strut migration and caval erosion into adjacent organs. Whereas percutaneous techniques for removal are preferred, in certain cases this is not possible and open retrieval is necessary. We present outcomes of various approaches to six cases of open IVC filter retrieval.

Endovenous thermal ablation has become the procedure of choice in the treatment of superficial venous reflux disease. The current armamentarium of devices and techniques aimed at the elimination of saphenous reflux offers surgeons and interventionalists a variety of treatment options; however, there is a lack of data comparing the safety of these products. The most concerning complication after endovenous thermal ablation is endothermal heat-induced thrombosis (EHIT) because of the risk of progression to deep venous thrombosis.

We sincerely thank Drs Antoniou and Georgiadis for their interest in our recently published study titled “A systematic review and meta-analysis of one-stage versus two-stage brachiobasilic arteriovenous fistula creation”1 and acknowledge their expertise in meta-analyses as evidenced by their own publications.

We sincerely thank Drs Antoniou and Georgiadis for their interest in our recently published study titled “A systematic review and meta-analysis of one-stage versus two-stage brachiobasilic arteriovenous fistula creation”1 and acknowledge their expertise in meta-analyses as evidenced by their own publications.

We read with great interest a systematic review and meta-analysis of one-stage vs two-stage brachiobasilic arteriovenous fistula creation published in the July 2018 issue of the Journal of Vascular Surgery.1 The review authors found an insignificant difference in all but one of their defined primary outcomes (2-year primary patency). They present the results of their significant finding (2-year primary patency) in a forest plot (Fig 2 in the review authors' paper). We would like to make the following remarks on the methodology of the study.